14120068CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10241 STONYDALE DR CONTRACTOR: HUY THE BUI ELECTRIC PERMIT NO: 14120068
OWNER'S NAME:
FREMONT, CA 94539 PHONE NO: (408) 206-0337
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
LICENSED CONTRACTOR'S DECLARATION
REMODEL (E) MASTER & HALL BATHROOMS,
Tic. # ��� �h
License Class cI C jrr��.
NON-STRUCTURAL WALL RECONFIGURATION (127 S.F.)
�" Date
Contractor } ��[ 1
I hereby affirm that I a9d licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
Valuation: $18000
pe formance of the work for which this permit is issued.
Sq. Ft Floor Area:
Zave and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
APN Number: 32637017 00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DA I2MIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
180 DA CALLED INSPECTION.
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
of the
costs, and expenses which may accrue against said City in consequence
e: !i
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
RE -ROOFS:
" ( Signature Date 2
All roofs shall be inspected prior to any roofing material being installed. If a roof is
for
installed without first obtaining an inspection, I agree to remove all new materials
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
HAZARDOUS MATERIALS DISCLOSURE
1, as owner of the property, am exclusively contracting with licensed contractors to
the (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
construct project
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Section 25532(a) should I store or handle hazardous
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Health & Safety Code,
material. Additionally, should I use equipment or devices which emit hazardous
defined by the Bay Area Air Quality Management District I
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sectio 5505, 25533, a d 25534.
t -
for this
Date: r
Section 3700 of the Labor Code, for the performance of the work which
Owner or authorized agent:
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
I hereby affirm that there is a construction lending agency for the performance of
become subject to the Worker's Compensation provisions of the Labor Code, I must
work's for which this permit is issued (Sec. 3097, Civ C )
forthwith comply with such provisions or this permit shall be deemed revoked.
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
may accrue against said City in consequence of the
I understand my plans shall be used as public records.
costs, and expenses which
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9 18.
Signature Date
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 FAX (408) 777-3333 • building
Ccupertino.org
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PROJECT ADDRESS
7APN # �? �J / _ 2 9 ` (D I -
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OWNERNAME
CONTACT NAMEJ
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PHONE q06 - /-10
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E-MAIL' n; .
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STREET ADDRESS ^ � /
CITY, STATE, ZIPP C
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FAX
OWNER ❑ OWNER•BU2DE OWNER AGENT 11 CONTRACTOR ❑ CONTRACTOR AGENT [n ARCHITECT ❑ ENGINEER 11 DEVELOPER 11 TENANT
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LICENS YPE
BUS. LIC G� 3 U
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FAX
STREET A DRE
CITYTAS TE, ZIP
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P ONNol
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ARCHITECT/ENGrNEER NAME
LICENSENUMBER
BUS. LIC #/
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK permi
vvv m re de-(-% k
EXISTING USE
PROPOSED USE CONSTR
TYPE
# STORIES
USE TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
AREt
NEW FLOOR
AREAVS-0
DEMO
AREA
I
TOTAL
NET AREA
T
��
BATHROOM KITCHEN
OTHER
REMODEL AREA `n REMODEL AREA ��.
REMODEL AREA
PORCH AREA
DECK AREA TOTAL DECK/PORCH AREA
I GARAGE AREA: DETACH
❑ ATTACH
# DWELLING UNITS:
IS A SECOND UNIT DYES
SECOND STORY DYES
BEING ADDED? ❑NO
ADDITION? QiiO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
O O O�
By my signature below, I certify to each of the following: I the property owner or authorized on the property own 's behalf. I have read this
application and the information I have provided is correct. ave read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building constructio authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: 1 0 — / W ('-I>
SUPPLEMENTAL INFORMWiTNREQUIRED.,+
° " •�°'''
OTJNT�E�2
LDI�'G;PLANTRE,,VIEW�s� ���.
New SFD or Multifamily dwellings: Apply for demolition permit for
_
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
� �-B
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
I
{ uBLlcwolixs7
form if any Hazardous Materials are being used as part of this project.h
_ Copy of Planning Approval Letter or Meeting with Planning prior to
0"iaSEWR AIS
submittal of Building Permit application.
RON]YIEN'IIALHEAI
BldgApp_2011.doc revised 06/21/11
M
CITY OF CUPERTINO
7n C1T7A ii A Tl113 lDTTTT 7 ll%Td" nl[VTCT(lN
1' iJ1:J JJ1.l 1 ilrlt 1 i
— —
— --
QTY/FEE
ADDRESS: 10241 STONYDALE DR
DATE: 12/15/2014
REVIEWED BY: MELISSA
19APN: 326 37 017
BP#:
*VALUATION: $18,000--�
':PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY—.—[
SFD or Duplex
PENTAMATION 1 R3SFDREM
PERMIT TYPE: i
USE:
PME Plan Check:
WORK
REMODEL E MASTER & HALL BATHROOMS NON-STRUCTURAL WALL RECONFIGURATION
SCOPE
(127 S.F.)
1'Ixrsxl7. 1'(ari (r c� I_ he"". Plan C hack
Peiv 1 F,e'e: l'ltd af3. I'r:r»Z;t l ee: f
01her Plumb Tnap. tJst�eti �<:€. ffts7:�.
Li
Tl711Ytt"). Fee: aee. Imp. L'C6:
rc_ rv__.•_.. c:.... 0,...s...... Q,,...,r• [)icfrint .Qrbnn/
NOTE: This estimate does not include fees aue to other uepartmems (i.e. uturtamg, . �..r�... �• ��, - •• ��•-- _.. __ _ ____ _ _ _, _
fir, [)ant inr ndfln'l info_
District, etc.. these tees are oasea on me preurrurtu,
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13)
rra vrnouoav1.
FEE
— --
QTY/FEE
_._
MISC ITEMS
Plan Check Fee:
$0.00
= s.£
$645.00
Remodel, Bath (<=300 sf)
IREMRESBAT
Suppl. PC Fee: (D Reg. ® OT0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -.(E) Reg. ® OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction TUX."
1cdnr'tri tr ti °> 1'£ f:
0
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
A
Tra ol, %.)oel'arle:ntatio n Fees:
Strony Motion Fee: IBSEISMICR
$2.34
Select an Administrative Item
$645.00 TOTAL FEE': $648.34
Bldg Stds Commission .Fee: IBCBSC
`
$1.00
3.34
meviseu. UO// -U// -U 1•+
Corridor
II �
II �
2'-6" 0'-4"
New closet openingrR
- t,/1
o UPER t INO
Medicine \ R' ® '1 S(li djna CA
cabinet y N .1n,;3rtMent
N (Bench'
7 -
7
GFCI SI SV
Step/ U GJ
Shower U
R R Vanity enclRosure ed By (,ply��t-1ANCa�
I
I eV BW
R I i1
T _ Vanity
Tub
=_ J 32"x60" o d'
,
' I -
Bedroom 1' -101. 3' - 0" 2'- 6" J,-JO.. iO 3' - 10" 8 Master Bedroom
YRS(
64.33 SF
eo kq
00 74.22 SF
17'7 r/7 GFCI /,
7'-4" -8" SS
Level 1 Eexisting New plan L Eexisting
1 window window
sarit B. Schwarz Design 960 Terrace Drive l_.os Altos
10241 Stonydale Drive, Cupertino APN# 326-37-017 650.863.4702 saritbschwarz@gmail.com
Scope of work: remodeling 2 bathroom, reconfigure the space, uptate lighting and
Address t o2 c, I
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingQa cuoertino.org
/_I f, Permit No.
i (2-0()6�
0/U �'1� �1 # of Alarms Smoke: -AT Carbon Monoxide:
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section 8314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations:
I
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: h -t dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
I have read and agree
............. ....................................... Date: ,. .4b ... .
Contractor Name: —
k-IC4 t Si nature..... .................... ........................ Lic.# ... ....... Date: �6
— / _.-%.3
Smoke and CO form.doc revised 03/18/14
CUPERTINO
Owner N
Address
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
9/ -No Go to Question 2.
2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its
plumbing, installation of water -conserving plumbing fixtures is not technically feasible?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply.
❑ The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
"o Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
fro Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
❑ No My real property is built and available for use or occupancy after January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
t? Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Check one.of the three following statements and sign
bottom of form..
Please check ONE of the following:
"y property is a single-family residential real property. See Civil Code Section 1101.4.
On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures
to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non-
compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether
property undergoes alterations or improvements).
❑ My property is a multifamily residential real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
❑ My property is a commercial real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-cornpliant plumbing fixtures shall be replaced with water- conserving
plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements).
I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's
installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the
table on the followine page. /
Division in order to final your building rmit.
SB4072015.doc revised 08/26/15
BUILDING PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS
CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015. doc revised 08/26115
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate
Fixture Type
Water Usage
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
/Flow Rate
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
Residential
Residential
Water Closets
Exceed 1.6
Single flush toilets: 1.28 gallons/flush
(Toilets)
Gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
average flush volume of two reduced flushes and one full flush
Urinals
Exceed 1.0
0.5 gallons/flush
Gallons/flush
Showerheads
Exceed 2.5
2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minute
U.S. EPA WaterSense Specification for Showerheads
(A hand-held shower is considered a showerhead.)
For multiple showerheads serving one shower, the combined flow rate of all
showerheads and/or other shower outlets controlled by a single valve shall not
exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets —
Exceed 2.2 gallons
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory
per minute
minute @ 60 psi; minimum
Maximum 1.5 gallons
psi
Faucets
0.8 gallons per minute @
per minute @ 60 psi;
20 psi
minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 si
Faucets —
Exceed 2.2 gallons
1.8 gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2
minute @ 60 psi, and must
gallons per minute @
default to maximum
60 psi, and must
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@ 60 psi
the above are unavailable,
Where faucets meeting
aerators or other means
the above are
may be used to achieve
unavailable, aerators or
reduction.
other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015. doc revised 08/26115